Sigmoid vaginoplasty: Long-term results

Kapoor, Rakesh; Sharma, Deepti; Singh, Kamal Jeet; Suri, Amit; Singh, Pushpa; Chaudhary, Himanshu; Dubey, Deepak; Mandhani, Anil

doi:10.1016/j.urology.2005.12.037

Cited by 68 publications

(43 citation statements)

References 12 publications

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“…Excess mucosal discharge with malodour was reported by some authors in 8.3% of patients after rectosigmoid vaginoplasty (24) while others reported no mucous problem (25,26). In our series, this was not a problem as this secretion decreased markedly within 2-5 months postoperatively.…”

Section: Discussionsupporting

confidence: 46%

Surgical and functional outcomes of sigmoid vaginoplasty among patients with variants of disorders of sex development

2012

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PURPOSE:To assess the use of sigmoid colon in vaginal reconstruction of some patients with disorders of sex development. MATERIALS AND METHODS: The study included 31 patients with disorders of sex development of various causes. All were reared as females. Female gender was decided for all cases after complete medical assessment. All patients underwent sigmoid vaginoplasty. Assessment of surgical and functional outcomes was carried out in a follow up period of up to 6 years. RESULTS: The preoperative diagnoses included mullerian aplasia (16 cases), androgen insensitivity syndrome (12 cases) and previous failed vaginoplasty (3 cases). Associated surgical procedures were gonadectomy in 5 cases and gonadectomy combined with clitoroplasty and vulvoplasty in 7 cases. No intra-operative or early postoperative complications occurred. A cosmetic neovagina with adequate size was achieved in all cases. Long term follow up showed introital stenosis in 4 cases (12.9 %). Two of them responded to vaginal dilatation. The third one needed y-v plasty while the fourth one presented by acute abdomen secondary to ruptured vagina and was submitted to urgent laparotomy. Mucosal prolapse occurred in 1 case (3.2%). Reoperation rate was 9.6%. Sexual satisfaction was achieved among 9 sexually active cases. The subjective satisfaction score of the surgical outcome was 8.03. CONCLUSIONS: For patients with disorders of sex development of various etiologies, sigmoid vaginoplasty is the preferred technique for vaginal replacement. It is a safe technique that provides the patient with a cosmetic neovagina of adequate caliber and a satisfactory functional outcome

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Section: Discussionsupporting

confidence: 46%

Surgical and functional outcomes of sigmoid vaginoplasty among patients with variants of disorders of sex development

2012

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“…Complications of intestinal neovagina include stenosis of the bowel segment which appears more common when small bowel is employed [Hensle and Reiley, 1998], mucosal or entire neovaginal prolapse [Hensle and Reiley, 1998;Parsons et al, 2002;Rajimwale et al, 2004] excessive mucus production, and bleeding which can require removal of the bowel segment [Parsons et al, 2002;O'Connor et al, 2004;Rajimwale et al, 2004;Kapoor et al, 2006]. Multiple attempts at creation of the neovagina or concominant use of bowel for other organs including Mitroffanoff formation can result in short bowel syndrome and its associated sequelae.…”

Section: Intestinal Vaginoplastymentioning

confidence: 99%

Management of Vaginal Hypoplasia in Disorders of Sexual Development: Surgical and Non-Surgical Options

Deans

Berra²,

Creighton³

2010

Sex Dev

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Patients with disorders of sexual development (DSD) requiring vaginal reconstruction are complex and varied in their presentation. Enlargement procedures for vaginal hypoplasia include self-dilation therapy or surgical vaginoplasty. There are many vaginoplasty techniques described, and each method has different risks and benefits. Reviewing the literature on management options for vaginal hypoplasia, the results show a number of techniques available for the creation of a neovagina. Studies are difficult to compare due to their heterogeneity, and the indications for surgery are not always clear. Psychological support improves outcomes. There is a paucity of evidence to inform management regarding the optimum surgical technique to use, and long-term data on success is lacking, particularly with respect to sexual function. In conclusion, vaginal dilators remain the cornerstone of treatment of women with vaginal hypoplasia and should be used as the first-line technique. Surgical vaginoplasty has a role in complex patients with previous failed dilation and surgical intervention, particularly those cases where there is significant scarring from previous surgery. Regardless of the vaginal reconstruction technique, patients should be managed in a multidisciplinary team where there is adequate emotional and psychological support available.

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“…11,12 In our series three had perineal rash induced by neovaginal discharge that disappeared after irrigation of the neovagina , mild ileus in 3 patients, one had a mild urinary tract infection and one had minor abdominal wound infection which responded to antibiotics.…”

Section: Discussionmentioning

confidence: 60%

Surgical and functional outcome of sigmoid colon-vaginoplasty in Mayer-Rokitansky-Kuster-Hauser syndrome

Pan¹

2017

Int J Reprod Contracept Obstet Gynecol

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Background: The objective of this study is to report our experience with sigmoid vaginoplasty in adolescent female patients of Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome with emphasis on the effectiveness of surgery, complications, sexual and functional outcomes.Methods: A retrospective study of adolescent females with vaginal atresia and Mayer-Rokitansky-Kuster-Hauser syndrome. The sigmoid segment was used for vaginoplasty in all the case.Results: Eleven females were studied over a period of 15 years. Postoperative complications were perineal rash in 3, ileus in 3, and minor wound infection in 1 patient and urinary tract infection in one patient. Nine patients were on regular follow-up. All the neovaginas were patent and functional. The postoperative mean vaginal length was 12.1 cm (range 11 cm to 14 cm). One of the patients had mild vaginal stenosis which responded to vaginal dilation, one had mucosal prolapse of the neovagina, one had excessive mucus discharge, during follow-up visits. Out of the 11patients, 8 patients are sexually active and 7 reported that they were engaging in satisfactory sexual activity with mild or no pain, and with good mucosal sensitivity. Only one experienced dyspareunia and three patients had not participated in sexual activity.Conclusions: Sigmoid vaginoplasty is a safe and acceptable procedure for vaginal agenesis with good cosmetic results and acceptable complications rate. Sigmoid colon vaginoplasty is the treatment of choice because of its large lumen, thick walls resistant to trauma, adequate secretion allowing lubrication, not demanding prolonged dilatation and short recovery time.

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Sigmoid vaginoplasty: Long-term results

Cited by 68 publications

References 12 publications

Surgical and functional outcomes of sigmoid vaginoplasty among patients with variants of disorders of sex development

Surgical and functional outcomes of sigmoid vaginoplasty among patients with variants of disorders of sex development

Management of Vaginal Hypoplasia in Disorders of Sexual Development: Surgical and Non-Surgical Options

Surgical and functional outcome of sigmoid colon-vaginoplasty in Mayer-Rokitansky-Kuster-Hauser syndrome

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